Assessment of cardiac involvement in myotonic muscular dystrophy by T1 mapping on magnetic resonance imaging

Evrim B. Turkbey, Neville Gai, João A.C. Lima, Rob J. Van Der Geest, Kathryn R. Wagner, Gordon F. Tomaselli, David A. Bluemke, Saman Nazarian

Research output: Contribution to journalArticle

28 Scopus citations

Abstract

Background: Patients with myotonic muscular dystrophy (DM) are at risk for atrioventricular block and left ventricular (LV) dysfunction. Noninvasive detection of diffuse myocardial fibrosis may improve disease management in this population. Objective: To define functional and postcontrast myocardial T1 time cardiac magnetic resonance characteristics in patients with DM. Methods: Thirty-three patients with DM (24 with type 1 and 9 with type 2) and 13 healthy volunteers underwent cardiac magnetic resonance for the assessment of LV indices and the evaluation of diffuse myocardial fibrosis by T1 mapping. The association of myocardial T1 time with electrocardiogram abnormalities and LV indices was examined among patients with DM. Results: Patients with DM had lower end-diastolic volume index (68.9 mL/m2 vs 60.3 mL/m2; P =.045) and cardiac index (2.7 L/min/m2 vs 2.33 L/min/m2; P =.005) and shorter myocardial T1 time (394.5 ms vs 441.4 ms; P <.0001) than did control subjects. Among patients with DM, there was a positive association between higher T1 time and LV mass index (2.2 ms longer per g/m2; P =.006), LV end-diastolic volume index (1.3 ms longer per mL/m2; P =.026), filtered QRS duration (1.2 ms longer per unit; P =.005), and low-amplitude (<40 mcV) late-potential duration (0.9 ms longer per unit; P =.01). Using multivariate random effects regression, each 10-ms increase in myocardial T1 time of patients with type 1 DM was independently associated with 1.3-ms increase in longitudinal PR and QRS intervals during follow-up. Conclusions: DM is associated with structural alterations on cardiac magnetic resonance. Postcontrast myocardial T1 time was shorter in patients with DM than in controls, likely reflecting the presence of diffuse myocardial fibrosis.

Original languageEnglish (US)
Pages (from-to)1691-1697
Number of pages7
JournalHeart Rhythm
Volume9
Issue number10
DOIs
StatePublished - Oct 1 2012
Externally publishedYes

Keywords

  • MRI
  • Myotonic muscular dystrophy
  • T1 mapping
  • Ventricular function

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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    Turkbey, E. B., Gai, N., Lima, J. A. C., Van Der Geest, R. J., Wagner, K. R., Tomaselli, G. F., Bluemke, D. A., & Nazarian, S. (2012). Assessment of cardiac involvement in myotonic muscular dystrophy by T1 mapping on magnetic resonance imaging. Heart Rhythm, 9(10), 1691-1697. https://doi.org/10.1016/j.hrthm.2012.06.032